The purpose of this study is to develop recommend items based on literature review and expert opinions,and to provide a reference for the revision of instructions for authors of Chinese biomedical journals.A research team extracted relevant items related to the revision of instructions for authors through literature review to generate preliminary items.Then the Delphi expert consultation method,combined with on-site discussions,was applied to generate core and recommended items.A total of 26 experts led by The Biomedical Journal Committee of the Shanghai Society for Scientific & Technical Periodicals participated in the Delphi expert consultation,with the opinions of 24 experts finally included.After two rounds of Delphi expert opinion solicitation,113 items were categorized into four parts,comprising 71 core items and 42 recommended items.The establishment of guidelines for recommended items in Chinese biomedical journal instructions helps to address ethical issues arising from the development of the internet and digital technology,as well as emerging medical advancements,and provides a reference for the revision of instructions for various biomedical journals.